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Underground Storage Tank <br />Spill Containment Testing Report Form <br />6. SPILL CONTAINMENT DETAILS <br />Test Method Developed by ❑ <br />Manufacturer a Industry Standard ❑ Professional Engineer <br />Test Type ❑ <br />Pressure ❑ Vacuum <br />a Hydrostatic <br />❑ Check this box if Appendix 6.1 continuation page is attached. <br />Tank IID <br />87 Fill! <br />91 Fill <br />DSL Fill <br />Spill Containment Manufacturer: <br />OPW <br />OPWOPW <br />Method of Cathodic Protection <br />a Nonmetallic <br />a Nonmetallic <br />8 Nonmetallic <br />❑ Nonmetallic <br />❑ Other <br />❑ Other <br />❑ Other <br />❑ Other <br />Is the spill containment <br />e Yes <br />S Yea <br />e Yes <br />❑ Yes <br />minimum capacity five gallons <br />excluding riser volume? <br />11 No* <br />11 No" <br />❑ Noy' <br />❑ No* <br />Method to keep spill <br />❑ Drain <br />D Drain <br />❑ Drain <br />D Drain <br />containment empty <br />e Pump <br />d Pump <br />a Pump <br />❑ Pump <br />D Other <br />D Other <br />D Other <br />❑ Other <br />Spill Containment Test Results <br />d Pass <br />N Pass <br />d Pass <br />D Pass <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />Tank ID <br />87 Vapor <br />91 Vapor <br />DSL Vapor <br />Spill Containment Manufacturer: <br />OPW <br />OPW <br />OPW <br />Method of Cathodic Protection <br />It Nonmetallic <br />IS Nonmetallic <br />N Nonmetallic <br />El Nonmetallic <br />❑ Other <br />Q Other <br />❑ Other <br />❑ Other <br />Is the spill containment <br />It Yes <br />w Yes <br />R Yes <br />❑ Yes <br />minimurn capacitor five gallons <br />excluding riser volume" <br />D No* <br />E3 fV <br />D No* <br />b fdoi <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />❑ Drain <br />Method to keep spill <br />containment emptor <br />a Pump <br />e Pump <br />a Pump <br />❑ Pump <br />❑ Other <br />❑ Other <br />❑ Other <br />D Other <br />Spill Containment Test Results <br />a pass <br />a Pass <br />11111 -pass <br />D Pass <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />7. COMMENTS <br />' D heck this box if any spill containment Inas less than 5 gallons capacity and requires <br />replacement. <br />Describe a8 answers marrre0 "OVier, 'No," or "Fe"" alld each proposed remedy in Sec#rOf) 7. <br />Page 2 of <br />